| NPI | 1043693104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-43832) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA R10435) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2019-01-31 |